Abstract
Employing the services of Nursing Homes is becoming a huge trend in the United States in recent years. Families can bring their elderly and ailing love ones to these nursing homes and pay for a certain cost to support their treatment. However, there is a growing debate within the country with regards to the use of these nursing homes as some groups believe families should take care of their love ones at home. Supporters to these alternative facilities argue that nursing homes would provide better care to their love ones, especially given the financial and living conditions. This paper will discuss the arguments surrounding the use of nursing home for love ones and answer as to why placing them to these homes would be beneficial or disadvantageous for the families thinking of using the service.
Placing Love Ones in Nursing Homes
When a person reaches the age of 70, family members would start clamoring for ideas as to what would be done in order to take care of their elderly family member. Some families opt to consider assigning someone to take care of their love ones at home due to the strict schedules of people today. Others would take care of their love ones by themselves due to the sentiment that it is the child’s responsibility to give back to their love ones. However, in recent years, there is a growing interest in many families to seek the assistance of nursing homes in order to take care of these elderly or ailing family members. Positions have greatly varied within the public regarding the presence of these nursing homes. Some argue that these nursing homes should not be trusted, while a few welcome its use. Families should place their love ones in nursing homes because these love ones would be taken care well by these nursing homes as they specialize in taking care of the specialized needs of these elderly and ailing family members despite the costs it entails.
The exact definition of nursing homes have varied throughout the years given the lack of terminology for these services in the early years. However, according to Giacalone (2001), the National Center for Health Statistics (NCHS) defined nursing homes as “facilities with three or more beds that is either licensed as a nursing home by the state, certified as a nursing facility under Medicare or Medicaid, identified as a nursing unit in a retirement center, or determined to provide nursing or medical care”. Some institutions also call these facilities as extended care facilities, intermediate care facilities for the mentally retarded and SNFs. Nursing homes often have state-of-the-art medical facilities and medical staff that can be called to duty 24/7. Before nursing homes can operate in the United States, they would have to apply for state licenses and adhere to reimbursement regulations, classification and termination policies. Most of these policies vary per state and some states would require separate licenses for nursing homes that have separate operations on all-day care facilities or medical accreditation .
Purdy (2013) stated that nursing homes became known in the US since the 1930 when many American families brought their ailing family members to “poor houses.” Many criticized these poor houses due to their deplorable living conditions and health care. In 1935, the Congress passed the Social Security Act which was included in the New Deal program to support its aging population. Federal grants were given per state in order to improve health care, as well as the creation of nursing homes for the elderly and ailing. By the 1950s, nursing homes were licensed and at the same time, criticized for their operations. From the 50s to the 80s, exploitation was prominent in the industry and misled many Americans in the process. The government immediately responded in 1965 by passing the Older Americans Act and the Title III grants which would establish the community program for the elderly which would cater not just for their medical needs but also for their maintenance. Studies were also supportive over the initiative of the government and aided in the establishment of the Nursing Home Reform Act of 1987, which would regulate Medicare and Medicaid in providing financial assistance to nursing homes. The Act also added the necessary requirements for nursing home licensing.
Since the growth of these nursing homes throughout the country, there are several sentiments that have been raised with regards to leaving loved ones in these nursing homes. Opponents cited three major arguments against nursing homes: cost and quality, reduction of self-reliance and independence and the trauma it entails to the loved ones. In terms of costs, it is reported by Ellis (2013) that nursing home services now costs up to $80,000 a year in comparison to its $67,527 five years ago. According to the Genworth 2013 Cost of Care Survey, factors such as insurance, food, maintenance and labor have triggered the increase of nursing home costs. As a result of these higher costs, a simple semi-private room nowadays now rate up to $75,405, 23% higher than it was five years ago. With these high fees, people tend to prefer using assistive living facilities that cost only up to $41,400. Others also prefer at-home care because it is cheaper to do these treatments at home, and they would also find it cheaper to pay for food and services .
Hand in hand with the high costs is the quality of care these nursing homes can provide to family’s loved ones. Pesis-Katz, Phelps, Temkin-Greener, Spector, Veazie, and Mukamel (2013) stated that consumers are often misled by the high hotel-like quality of nursing homes around the country due to the misleading and inaccurate information available. Some of the information available for prospect residents come from the internet and sometimes, it is not easy to understand. Since customers cannot interpret and understand the information with regards to the quality of health care, they often prefer to select nursing homes with high grade hotel type service. They often use indirect methods to observe if the nursing home is good for their love ones. Some factors they take into consideration are nonprofit ownership and the number of occupancy, seeing it as a sign for high quality for its service and capability. As a result of the inconsistency of information, it is likely that the service they would get would not be suitable for their love ones .
Loved ones who are placed in these nursing homes also feel the reduction of self-reliance and independence. According to the Illinois Council on Long Term Care (n.d.), any person who is admitted to nursing homes would lose their privileges to keep their apartments and homes. Most of their possessions would also be sold or given to charity, removing the possibility for the person to give the possessions as an inheritance to their children or grandchildren. Nursing homes only allow just a few possessions for these loved ones to hold; however, they would have to fit it on a small space that sometimes, they share with another person. Aside from losing their homes, loved ones admitted to nursing homes would also cause a loss of status, finances and relationships that may affect the loved one’s confidence and independence. Residents are also restricted from their movements considering that every activity is now timed by the institution and where the resident would need to stay.
Finally, there are also implications to loved ones when they are placed in nursing homes, mostly changing their attitudes and development of trauma. Many would become angry for being placed in a nursing home especially with the loss of their possessions and rights. Some elderly often get angry because of the restrictions placed on their movements while in these institutions. As a result of their anger, they would become trouble-makers in the nursing home and it may hinder their recovery. Some, especially those who lose their love ones prior to their admission to these institutions, would feel bouts of depression or even regression. These residents would become overly dependent towards their caretakers or their love ones. There are also bouts of denial for these residents as they would feel that their condition or placement in the nursing home is not true. They believe that they would be removed from these centers soon and go home afterwards .
However, while there are people against the use of nursing homes in the country, many Americans today prefer to use nursing homes due to the benefits it has for both the family and the love one that would be enrolled in this service. Many often prefer sending their loved ones on these nursing homes due to the all-round care provided by these facilities. According to the report by Sun Advocate (2008) and EHealthMedicare (n.d.), many of America’s nursing homes have available professionals to cater to emergencies and immediate medical support 24 hours a day. While doctors may not always be available in the early hours of the day, nurses are trained to take care of their patients and do rounds regularly. If these love ones were taken care of at home, their family members would not be able to cater to the exact need of the ailing or elderly loved one. The family would have to adopt with the schedule of the elder, which may prevent them from going to their own duties on time. With nursing homes available, families can visit their family members on free days and be assured that their love ones are treated and monitored regularly.
In addition, these professionals and personnel can also provide specialized treatment necessary to improve the health and well-being of the citizen. Nursing homes have custodial care, which aids in preparing meals, bathing and dressing for their residences. The skilled nursing care unite is where the nurses and rehabilitation specialist would determine what type of care or treatment would be done. This type of care would include activities such as medication management, wound care and specialized functions depending on the availability of medical equipment in the facility. Some facilities also offer rehabilitation services, especially for patients which have been placed under surgery and other strenuous activity. The doctor of the resident would be able to determine as to how long rehabilitation would occur. Finally, nursing homes are also well known for their long-term care facilities to aid patients with major diseases. Prescription drugs and medical supplies are also readily available for use by these workers to ensure continuous service and treatment for residents.
Nursing homes also allow their love ones to meet up new friends and acquaintances as nursing homes are like small communities. In at-home treatments and care, the elderly or ailing family member would only have limited contact with their peers. However, in nursing homes, they are able to be with their age group and even go on regular social gatherings and celebrations: may it be visits to museums or simple group meals in the nursing home. In some instances, nursing homes actually incite socialization given that the nursing home acts as a special home for its patients and residents. They can use the open kitchens and public areas to meet up with their fellow residents. Nursing homes also may have sectors catering for other in-need residents, who are not necessarily elderly. They may also find certain nursing homes that would permit couples in staying together to provide a good environment for their development and recovery.
Nursing homes are also quite safe and promises to provide excellent service as these nursing homes are regularly checked by the United States government for their capacity and services. Medicare and Medicaid also provide regular reviews to the public in order to determine which nursing homes adhere to their policies. Evaluations are done regularly to ensure that quality is not compromised and it is expected that nursing homes update their programs to stay up-to-date to the new improvements in healthcare . Nursing homes also make sure that patients do not endanger themselves further especially with the onset of very complicated diseases like dementia and Alzheimer’s .
Family must always be cherished no matter what one feels about each family member. As these family members get older, it is crucial that they are given all the love and care possible to make their lives comfortable in their final years. However, taking care of these ailing and elderly family members can be very difficult especially due to the medical and financial needs of these loved ones. With the introduction of nursing homes, families now have a choice to use these services to take care of their love ones. On the one hand, these nursing homes can be quite costly each year and it is a question as to whether or not the service matches the cost. These nursing homes can even make the situation of the elderly and ailing family members to worsen due to the impact of their residencies. On the other hand, using nursing homes not only benefits the family member but also the family in general. The family member would greatly benefit due to the ready access to health care, while family members would be relieved with the financial burden attached with taking care of these love ones.
References
Centers for Disease Control and Prevention. (2014, May 14). Nursing Home Care. Retrieved from CDC FastStats: http://www.cdc.gov/nchs/fastats/nursing-home-care.htm
EHealth Medicare. (n.d.). Nursing Homes and Medicare. Retrieved from EHealthMedicare: http://www.ehealthmedicare.com/about-medicare/nursing-homes/
Ellis, B. (2013, April 9). Nursing home costs top $80,000. Retrieved from CNN Money: http://money.cnn.com/2013/04/09/retirement/nursing-home-costs/
Giacalone, J. (2001). The U.S. Nursing Home Industry. New York: M.E. Sharpe.
Illinois Council on Long Term Care. (n.d.). Understanding the Transition to Life in a Nursing Home. Retrieved from Family Resource Center: http://nursinghome.org/fam/fam_004.html
Pesis-Katz, I., Phelps, C. E., Temkin-Greener, H., Spector, W. D., Veazie, P., & Mukamel, D. B. (2013). Making Difficult Decisions: The Role of Quality of Care in Choosing a Nursing Home. American Journal of Public Health, 103(5).
Purdy, E. (2013). Nursing homes. Ipswich: Salem Press.
Sun Advocate. (2009, April 10). Advantages and disadvantages of nursing home care for the elderly. Retrieved from Sun Advocate: http://www.sunad.com/index.php?tier=1&article_id=12944
